You are here

Dr P Kerr & Partners Requires improvement

Reports


Inspection carried out on 17 July 2019

During a routine inspection

We carried out an announced comprehensive inspection at Dr P Kerr & Partners (The Wall House Surgery) on 17 July 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

  • what we found when we inspected
  • information from our ongoing monitoring of data about services and
  • information from the provider, patients, the public and other organisations.

Overall this practice is rated as requires improvement.

We rated the practice as requires improvement for providing safe services because:

  • Information from correspondence was not always shared and actioned within the practice effectively.
  • The practice did not always have clear systems, practices and processes to keep people safe and safeguarded from abuse.
  • Appropriate recruitment checks and the ongoing monitoring of the registration of clinical staff was not always completed.
  • The practice could not always evidence the completion of actions resulting from safety alerts.

We rated this practice as requires improvement for providing effective services because:

  • The practice could not demonstrate that the immediate and ongoing needs of patients with long-term conditions and mental health conditions were being fully assessed.
  • The practice childhood immunisation uptake rates had not all met World Health Organisation (WHO) targets.

These areas affected people with long term conditions; families, children and young people; and people experiencing poor mental health, so we rated these population groups as requires improvement. The population groups of older people, working age people, and people whose circumstances make them vulnerable were rated as good.

At this inspection our key findings were:

  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • The practice had plans in place to improve their service to meet patients’ needs.
  • Patients found the appointment system easy to use and reported that they were mostly able to access care when they needed it.
  • Staff worked well together as a team. There was a culture of working together for a common aim.
  • The practice had a paediatric advanced nurse practitioner who offered and delivered a variety of services for families, children and young people to meet their needs. The practice was also breastfeeding friendly and had a GP infant feeding champion who promoted improvements to infant feeding education across primary care. Patients we spoke with were positive about the services offered for families and children.
  • The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

The areas where the provider must make improvements are:

  • Ensure that care and treatment is provided in a safe way.
  • Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

  • Review and improve the storage of completed staff induction checklists.
  • Continue to develop and document the practice strategy and business plan.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Inspection carried out on 5 January 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr P Kerr and Partners on 17 August 2016. The overall rating for the practice was Good. However, during this inspection we found a breach of legal requirements and the provider was rated as requires improvement under the safe domain, this was due to the fire alarms not being tested on a regular basis and prescription stationary not being managed safely. Following this inspection the practice sent to us an action plan detailing what they would do to meet the legal requirements in relation to the following:-

  • Ensuring that blank prescriptions forms used in printers were tracked and securely stored.
  • Ensuring the fire alarms were tested on a regular basis.

We undertook this announced desk based inspection on 5 January 2017. This was to confirm the practice had carried out their action plan to meet the legal requirements in relation to the breach in regulations that we identified in our previous inspection on 17 August 2016. Our review of the evidence has determined that the provider was now meeting all requirements and is now rated as good under the safe domain.

Our key findings across the areas we inspected for this inspection were as follows:-

  • Printers had been installed with a lock for the printer drawer which held prescription forms and the key was kept separately in a secure location. Serial numbers of prescriptions forms were tracked by the practice at all times.
  • The fire marshal undertook weekly fire alarm testing. An external company had completed an annual fire risk assessment in November 2016 and a new fire evacuation plan had been created. The practice undertook their own weekly fire risk assessment..

This report only covers our findings in relation to these topics. You can read the report from our last comprehensive inspection published on the 7 October 2016, by selecting the 'all reports' link for Dr P Kerr and Partners on our website at www.cqc.org.uk.


Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 17 August 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr P Kerr and Partners on 17 August 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Risks to patients were assessed and well managed, with the exception of the storage of blank prescriptions and the regular testing of fire alarms.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
  • Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of and complied with the requirements of the duty of candour.
  • The practice participated in the hospital admission avoidance scheme and maintained a register of patients who were at high risk of a hospital admission.
  • The practice ran regular paediatric asthma clinics ran by the paediatric advanced nurse practitioner.
  • The practice had signed up to the national breastfeeding friendly initiative. One of the GPs was the breast feeding support lead and a nurse was a breast feeding ambassador.
  • The practice registration system ensured that all patients had a face to face meeting with the senior administrator. This ensured that any additional needs of the patient were identified and any additional support could be arranged for the patient in order to access healthcare.
  • The practiced worked closely with local services including the Safe Haven café in Redhill (people are able to go to the café in the evenings rather than A&E if they feel in crisis due to mental health concerns).
  • The practice had also helped to create a Heart Failure Management Plan to empower patients to manage their own condition.
  • The practice was leading on education for postnatal contraception and had developed a leaflet for patients

The areas where the provider must make improvement are:

  • Ensure that blank prescriptions used in printers are tracked and securely stored.
  • Test the fire alarms on a regular basis

Additionally the provider should:-

  • Ensure patients with a learning difficulty or those with mental health problems have a new review and care plan in line with the practice’s new policy and procedures.


Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice